Diverticular disease: Nursing

Diverticular disease is a condition characterized by the formation of diverticula, which are small pouch-like protrusions that form along the walls of a hollow structure, most commonly, the large intestine. Having multiple diverticula in the colon is called diverticulosis. And if one or more of these diverticula become inflamed, that’s called diverticulitis.

Now, let’s zoom into the wall of the intestine, which is made up of four layers. The outermost layer is called serosa or adventitia. Next is the muscular layer, which contracts to move food through the bowel. After that is the submucosa, which consists of a dense layer of tissue that contains blood vessels, lymphatics, and nerves. And finally, there’s the inner lining of the intestine called the mucosa; which surrounds the lumen of the gastrointestinal tract and comes into direct contact with digested food.

Now, there isn’t a single cause of diverticular disease, but rather it’s a multifactorial disease, meaning that there’s a combination of genetic predisposition and environmental risk factors. These include age over 40 years old, consuming a diet low in fiber and high in fatty foods or red meat, being obese, and having a sedentary lifestyle. Other risk factors include smoking, alcohol use, and taking certain medications, like NSAIDs.

All right, now, regardless of the cause, there’s an increase in the pressure inside the colon. This pressure pushes on the mucosa and submucosa until they bubble out through weak spots along the wall, like where a blood vessel penetrates the muscle layer of the intestine. These blood vessels can get weaker and rupture, leading to gastrointestinal bleeding. In addition, bacteria and undigested food may get stuck inside these protrusions, and cause infection within the intestinal wall.